The dissertation was carried out in accordance with the defined goal – to provide medical and social justification for improving ophthalmological care for patients with diabetes mellitus. The achievement of the goal was based on a structured research program divided into sequential stages, at each of which the set tasks were performed according to the author's chosen methodology and using general scientific and specialized research methods: system approach and analysis, bibliosemantic, epidemiological, medical-statistical, sociological, content analysis, SWOT analysis, modeling, graphical methods, and expert evaluations.
It has been shown that 285 million people worldwide suffer from vision impairments, of which 39 million are affected by blindness and 246 million have reduced vision. Eye diseases have significant medical, social, and economic implications. The global losses from reduced productivity due to eye diseases are estimated at USD 411 billion annually. In young children with severe and irreversible vision impairments, there may be delays in psycho-emotional, motor, speech, and social development; in adults, depression and anxiety disorders may occur; and in the elderly, there may be difficulties in walking, an increased risk of falls and fractures. The main causes of vision impairment and blindness are refractive errors, cataracts, diabetic retinopathy, glaucoma, and age-related macular degeneration. Vision loss is more common in people over the age of 50 (WHO, 2006; 2013; 2019; 2023).
The results of a management audit conducted at the State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department, focusing on the quality of preventive medical examinations for adults over 18 years old and the identification of patients with diabetic retinopathy, revealed that referrals from endocrinologists for ophthalmological consultations were recorded in only 30% of Form 025/o entries. Information on the ophthalmological consultation was included in 75.6% of Form 025/o records. Results for glycated hemoglobin levels were provided in 93.26% of Form 025/o records, while results for fasting blood glucose levels were present in 100.0% of Form 025/o records. These findings indicate a deficient level of organization in the follow-up care of this patient group, and a low level of communication among the healthcare providers involved in medical care and preventive measures for patients assigned to the State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department.
The summary of the research results, the experience of implementing diabetic retinopathy screening programs in most European countries, and WHO recommendations on prevention, early diagnosis, treatment, rehabilitation, and organization of comprehensive ophthalmological services for patients with eye diseases, including those related to diabetes mellitus, formed the basis for the medico-social justification, development, and implementation of specific elements of a functional-organizational model for improving ophthalmological care for patients with diabetes mellitus.
